It Is A Man’s World: Evolving In A World Not Made For You

I am not talking about the consequences of systemic violence here. It is sadly known, especially within the targeted communities, that marginalized groups are at a higher risk of violence and/or death. The HRC (Human Rights Campaign) Foundation, an LGBTQIA+ organization fighting to change policies and institutions for the integration of the queer community, has officially stated that 2021 is the deadliest year so far for trans and non-binary people (HRC, November 2021). 

Domestic violence and masculine violence are still very high across the globe (The High Court, October 2021). In Switzerland, for instance, the average number of femicides per year has already been reached as of last October (Swiss Info, November 2021). And with the intersection of oppressions, the situation only gets worst: the #SayHerName campaign has been launched in 2014 to acknowledge the violence against black women. If you want to help, you can check Black Women Are Worthy, a project by Deun Ivory to support black sexual assault survivors. 

But what if I told you that our system also indirectly causes the death of women and marginalized groups, because of the lack of adequate equipment? What if I told you, we are dying because no one takes us into account when building equipment or testing medications (internally screaming)? Studies in France, for instance, have shown that serious injuries at work have decrease for men over the last years, but that they have increased for women (Equal Times, February 2018). So, let us take a trip down the risks of being part of a marginalized group. 

NB: this article remains, I am afraid, majorly binary, comparing between women and men. Maybe, one day, non-binary folks will be visible enough that studies are conducting including them as well. Sadly, the day has not come yet. 

NB bis: This article is not that fun, so make sure you are in the right state of mind before diving in - maybe fix yourself a nice cup of tea, or take a pillow to scream into. Whatever works for you. 

Car crash tests – Do you mean women drive too?

Let us start with cars, shall we. Studies point out two relevant statistics in our case: first, men cause far more deadly and violent car accidents than women (IIHS, March 2021). While men drive more than women on average, principle factors explaining this disparity are linked to dangerous behaviors: speeding, not wearing a seatbelt, alcohol, etc. Second, women (and especially young women) are more likely to die or be seriously injured than men in crashes of equal severity (IIHS, March 2021). In fact, when women are involved in a car crash, they are 47% more likely to be seriously injured, 71% likely to be moderately injured and 17% more likely to die than men (The Guardian, February 2019).

There are several explanations for this: first, a larger vehicle will hold better in a crash and, for some reasons (by chance, toxic masculinity?), men tend to drive bigger cars than women (Turbo, February 2021). Second, the person getting hit will get the most part of the damages – and, as we have just seen, men cause more serious accident than women (Turbo, February 2021). But there are two other factors at play here. 

Being ‘out of position’

Another reason that could explain the higher death rate of women in similar crashes is the ways cars are built and safety tests are conducted. For starter, you need to know that women tend to sit closer to the pedals and more upright, in order to be able to see over the dashboard, because they are, on average, smaller than men – we could also discuss how we perpetuate this height difference as heteronormative culture trains men to favor smaller women and women to favor taller men, but that would be a whole other article, so I will save it for another time. As a consequence of this, women tend to sit differently than men behind the wheel, meaning that they do not adopt the ‘standard seating position’ (The Guardian, February 2019). And I am going to stop there for a minute to collect myself. Because, if you think about it, women make up roughly half the world’s population (although I must add that gender repartitions still do not account for gender transitioning or for gender identities other than cis men and cis women). So, what made men think they could define what standard position is, leaving out half of humanity? (You do not need to actually answer, we all know what did). 

So, back to our driving positions then. Women are, according to men, ‘out of position’ drivers (The Guardian, February 2019). And you know what? I may need longer to collect myself here. Because not only are we not considered to be sitting according to the standards – we are out of position. Can you imagine the nerve you need to have to tell half of the population they are sitting wrong? But, anyway. Let us say the majority of women are sitting wrong. This actually changes the position of the legs, making them more vulnerable in the case of a car crash. On top of that, on average, women have less muscle in the neck and upper chest, which makes them more vulnerable to whiplash – and guess what? The way cars are conceived and built only makes it worse (The Guardian, February 2019). So, women are more likely to die in car crashes because the way cars are built do not take into account positions and morphological differences of half the world’s population. 

Crash-test dummies 

And if that does not make you angry, let us tackle the subject of crash-test dummies. Introduced in the 1950s, they have unsurprisingly been based on men’s average height, weight, muscle repartition and spinal column (The Guardian, February 2019). Despite the plea of Michigan University-based researchers in the 1980s, it was not until the 2010s that crash-tests started to include dummies (more or less) based on women’s average body. And by that, we actually mean smaller, still male-based dummies. Tested in the passenger seat only the vast majority of the time – because, you know, a real woman does not drive, she is shown around by her husband. Oh, and have I mentioned that these tests do not acknowledge pregnant people whatsoever, despite car crashes being the first cause of foetal death linked to trauma of the pregnant person (The Guardian, February 2019)? Yup. 

Sadly, not a lot of people are working on the issue. The exception is Astrid Linder, research director of traffic safety at the Swedish National Road and Transport Research Institute, who has developed a virtual crash dummy, based on the average woman’s body. But because it is not as widely used as she hoped it would be (no comment), she is currently working on developing a virtual version of a real human, rather than of a dummy (Discover, February 2021). It should be available as of 2021 – so, this year. I can only hope that it will be used and that it will lead to innovations increasing the safety of women on the road – and also, that more women and marginalized genders get hired in the fields to effectively change the policies. We are tired of dying because men do not think we are important enough to care for our safety. 

Personal Protective Equipment (PPE) – Not a Western white cis dude? Stay home, duh.

So, women are more likely to die on the road than men. But not only. This applies to the workplace as well. As mentioned in the introduction, data show that while men’s risks of severe injury at work have decreased in the last years, women’s risks are actually increasing. Part of the reason why has been that, a few years ago, women started to be more represented in manual fields, statistically leading to more injuries. But that is not sufficient to explain the disparity anymore. 

Workplace injuries and the lack of adequate equipment

In 2010, France’s Economic Social and Environmental Council stated that ‘there has been virtually no research from a gender perspective. The impact of occupational risk factors on women’s health remains in many ways invisible. They are unfamiliar, underestimated and consequently not properly taken into account.’ (Equal Times, February 2018). Fun, right?

Recent studies conducted in the UK on women and work have shown that 57% of the women responding found that ‘their PPE sometimes or significantly hampered their work’. (TUC, April 2017). The report goes further, pointing out that this is not really a surprise, as the standards for protective personal equipment are based on average white US and European cis men. As a result, most women, and also many men, experience problems finding suitable and comfortable PPE, because they do not conform to this standard male worker model. For instance, the 'use of a ‘standard’ US male face shape in the manufacture of RPE means that it does not fit most women as well as a lot of men from black and minority ethnic groups or with facial hair’ (TUC, April 2017). 

And, as with the crash dummies, employers have tried to adapt the equipment by simply downsizing it a bit. Unfortunately, this is not an ideal situation either. Indeed, some items need to be well-adjusted to provide adequate safety, like fall-arrest harness or safety boots. For these pieces of equipment, typically, differences in chest, hips, thighs and feet can affect the fitting and downgrade the safety of the equipment, leading to a higher risk of injury. Also, again, specific risks related to pregnancy are almost never accounted for. Existing safety equipment adapted to pregnant people is close to none and, even when it exists, employers are reluctant to buy it (TUC, April 2017). 

So, in conclusion, not only are marginalized groups harassed in the workplace, we are also more at risk of severe injury or death. You know what? I will not even comment on that anymore. I am just going to go scream in a pillow, be right back. In the meantime, you can check some cool projects on stopping workplace harassment, like Purple Campaign, or rehabilitating human trafficking victims through formation, like AnnieCannons, to change your mind before we continue. 

The case of the US 

I will say that, though: in the US, armed forces are developing military equipment best suited to women, from helmets that can accommodate buns, to urinary devices - women on mission were observed to have more urinary tract infections or to intentionally drink less, leading to dehydration and thus endangering their health (USA Today, October 2020). I personally have some issues with militarized states and invading other countries, but hey, at least they seem to care more about women’s health than the rest of the world. 

Or than NASA. Because, I know this is not life threatening, but I could not resist talking about it here. Did you know that NASA originally planned on sending an all-women team to space in March 2019? Awesome, right? Well, sorry to break it to you, but that had to be cancelled (NY Times, March 2019). Because NASA only had one spacesuit in M size (the others being size L or bigger) and both astronauts needed an M size. I mean, WTF NASA?

Medical issues and drug tests – Who cares about women’s health anyway?

Take a deep breath and let us move on to the next big piece: health. Because, my oh my, are we not ready for this. So here goes. 

Drug tests

First of all, clinical trials for drugs have historically been based on white cis men (Science Daily, August 2020). Yeah, I know, at this point it is starting to sound a little repetitive. What do you want me to say? The patriarchy f***ed us over. And if you think I am overreacting, wait until you know why we have ignored other genders in trials: cis women have consistently been discarded from clinical trials, because of concerns that ‘female hormone fluctuations render women difficult to study’ (Science Daily, August 2020). Yes, side effects have not been tested on women because scientists literally looked at each other like ‘bitches be hard to read, man’. 

Also, this is not backed up by evidence, but I am going to go on a limb here and assume that studies do not talk about the inclusion or exclusion of other genders and/or marginalized groups in clinical trials, because scientists simply ignore them. Oh and, by the way, people of color are also underrepresented in clinical trials. This means that women of color are doubly underrepresented (American Progress, July 2020) - and thus, at higher risk of being prescribed drugs that have not been safely tested for their group. 

The result of this is that women experience, on average, negative side effects twice as often as cis men. Indeed, they are often over medicated, as standard dosages are based on studies conducted on cis men (Science Daily, August 2020). Plus, because of drugs that had disastrous effects on fetuses and children worldwide,  like thalidomide – a German drug that affected the development of thousands of fetuses in the 1950s – pregnant people were discarded from clinical trials until the 1990s. This contributed to the underrepresentation of women and and non-cis men in trials as well.

PS: If you are interested in the subject of thalidomide, you can read more here.

Nowadays, legislations have been changed and trials are supposed to include cis women as well – no words on other marginalized groups, however; although, I cannot help but think that, if cis women hormones make them react differently to medication, so must trans women hormonal treatments. But despite this slight progress, one issue remains: the data is often not analyzed taking into account gender differences... (Science Daily, August 2020).  

On top of that, women are more included in the final phases of the trial, but continue to be underrepresented in the early stages, where data on dosage are collected (Health Line, October 2020).  Plus, Natalie DiPietro Magger, professor of pharmacy practice at Ohio Northern University, adds that in ‘trials that impact both men and women, some reports indicate that women are not always being enrolled at a level proportional to the levels at which they experience that disease state’ (The Pharmaceutical Journal, May 2020). So, even if laws have changed, we still have a long way to go. And meanwhile, the dosage of a lot of drugs are still not adapted to half of the population…

Cardiac problems

You thought this section was over? Oh, no. We are now tackling cardiac problems. You probably have this idea, as most of us, that cardiovascular diseases are mostly a men’s problem. But what if I told you that cardiovascular diseases are the leading cause of death for women in the US (NCBI, April 2016)? And that, despite declines in the overall mortality linked to cardiovascular diseases, data actually show a stagnation of the improvements of coronary heart disease in women younger than 55 years (NCBI, April 2016)? And that, in the UK, women are twice as likely to die of coronary heart disease as of breast cancer (NCBI, April 2016)?

This is explained by many different factors. First, a general lack of information on women’s heart diseases and the way they manifest themselves may have an impact on the diagnostic by doctors, delaying it (Harvard Health Publishing, October 2020). It also means that many women do not recognize the symptoms, because they are not necessarily identical to men’s heart diseases. This as well delays consultation and treatments for women (Harvard Health Publishing, October 2020). Indeed, studies on heart diseases have been majoritarily conducted on men. As a result, men’s symptoms are widely known, such as the typical chest pain. However, if women can experience chest pain as well, they are more likely to experience other symptoms, such as nausea, shortness of breath, dizziness or no symptom at all (Harvard Health Publishing, October 2020). Because we have not been taught that these could be symptoms of a heart disease, women often ignore them, leading to higher mortality rates. 

And I will make another parenthesis here, because articles that I have read on the matter state that the majority of women experience ‘atypical’ symptoms. Atypical. Because they do not fit the standards established on cis men only. I do not know if I am being clear enough here. Calling women’s typical symptoms of heart attack ‘atypical’ only goes to show that, up until now, you have only studied and cared for men’s symptoms... 

On top of that, women are less likely to be prescribed certain blood pressure medication compared to men (Harvard Health Publishing, October 2020). They also receive poorer heart attack treatment than men (The University Of Edinburgh, October 2019). A report of the British Heart Foundation on the subject actually found that this difference in treatment between men and women lead to ‘more than 8,000 women in England and Wales dying needlessly from heart attacks over the past decade’ (The University Of Edinburgh, October 2019). I may need my pillow again...

Delayed diagnostics: autism, dermatology and endometriosis

The fact that the majority of medical issues are studied solely on white cis men has an impact on an infinity of medical fields, although it is not necessarily or directly linked to an increase of mortality rates. And I felt like it was still important to briefly talk about it here. Typically, diagnostics in some fields, like the autism spectrum or dermatology, can be delayed, due to the white cis men norm. And, again, even if it does not necessarily threaten the life of the patients, it still lowers the quality of their life – which is unacceptable as well. 

Did you know, for instance, that autism in women is systematically less diagnosed than in men? Indeed, studies have shown that women are more likely to camouflage their autistic traits, thus going undiagnosed for years (Health Line, November 2021). However, the level of energy it takes to effectively camouflage autistic traits for years is tremendous, and no one should go through this. We should be able to provide everyone with the support, environment and help they need. 

Recently, people have also pointed out the lack of representation of dark skins in dermatology manuals. Indeed, many skin diseases manifest themselves differently on different skins. Most dermatology books, however, only display examples of diseases on white skins (Stat News, July 2020). This leads BIPOC patients to endure a much longer diagnosis-phase – if diagnosed at all. Again, this is not acceptable, as everyone should be able to receive the care and treatment they need. To fight this, Malone Mukwende, student at the St George Medical School, London, has published, in September of 2020, a book on how skin conditions look on black and brown skins (ABC News, September 2020).

And while we are on the subject of delayed diagnosis, we could also talk about endometriosis. This disease affects roughly 10% of people of reproductive age who have a uterus (WHO, March 2021). However, the diagnosis can take up to 10 years, because, as it does not affect cis men, no one cares that you suffer while on your period – worse, we are being told that this is normal. 

And I could go on and on, but I think I will stop myself here – I am running out of good pillows. Anyway, you get my point. 

In conclusion: we deserve not to die

I will say it loud and clear. Reform the system. Not everyone – and by not everyone, I mean the overwhelming majority of the world – fit the established norms. Heck even some white, cis, straight, abled men do not fit the norms. 

Keeping up with such biased standards not only perpetuates oppressions, but it is also life-threatening. And I think life is hard enough without risking dying because the drugs prescribed by your doctor have not been tested for your body. Also, why is that that psychology studies have to have a representative sample, including people from all genders, social backgrounds, ethnicities, levels of educations, professions and so on, but that medical studies or car-crash tests have been liked ‘yeah, just take people that look exactly like us, that will be enough’? Why are there no norms or obligations in these fields?

So, in conclusion, hire more women, people of colors, non-binary people, trans people, agender people, hire everyone from the full gender, sexuality, health and race spectrum. Make sure everyone is represented. Everyone deserves to be. Because, for certain things, not being heard is not only a question of representation. It is a matter of life or death. Heck, even being left-handed leads to a higher risk of dying because the world is not made for you (NY Times, April 1991). So why do we keep on trying to impose one biased, standard norm on the whole population? Well, I think we all know the answer. 

I know I might have ruined the mood a little, so if you want to leave on a less depressive note, you can check some amazing projects trying to change the norms worldwide: 

Cutecatcalls: Zoe Stromberg’s Fight Against Street Harassment
Girls Who Code: Closing The Gender Gap In Technology
‘Gurlz With Curlz’: An Aesthetic Space For Black Female Experiences In Germany
‘Women in Ocean Science’ Strives To Draw More Women In Scientific Careers
‘Disclosure’: A Vital Documentary On The Realities Of Trans People
Shamsia Hassani Is Fighting The Patriarchy One Graffiti At A Time
Modeling Agency Changing The Norms Of Gender

As always, do not forget to share your thoughts on our Instagram and take care. See you soon!

Love, xx

Header credits: Constante Ken Lim / Unsplash